This report summarises the most recently available data with regard to drug-related harms and drug-related harm interventions in the Republic of Ireland.

Ireland maintains a special register that is a complete census of all drug-induced deaths. Established in 2005, the National Drug-Related Deaths Index (NDRDI), which is maintained by the Health Research Board (HRB), is an epidemiological database that records cases of deaths by drug poisoning, and deaths among drug users in Ireland, extending back to 1998. Data for 2021 are included in this report.

Data on drug-related acute emergencies in the Irish context refer to all admissions to acute general hospitals with non-fatal overdoses and are extracted from the Hospital In-Patient Enquiry (HIPE) scheme. Data for 2023 are included in this report.

The Health Protection Surveillance Centre (HPSC) is notified of incidences of newly diagnosed human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Notification data for 2023 are included in this report.

There were 286 drug-induced deaths in 2021; the comparable figure for 2020 was 352. The majority of those who died were males in their early 40s. Opioids were the most common drug group associated with drug-induced deaths.

There were 4,381 overdose cases in 2024 discharged from Irish hospitals. Opioids were used in 16.0% (n=702) of cases, cocaine in 7.0% (n=306) of cases, and cannabis in 3.3% (n=146) of cases in 2024. No overdose cases (or five or fewer cases) involving lysergic acid diethylamide (LSD) or other hallucinogens were recorded.

According to data compiled by the HPSC, at the end of 2024, 1,009 people were newly diagnosed with HIV in Ireland, a notification rate of 19.6 per 100,000 population. This marks an increase of 10.8% compared with 2023 (n=911). Of the HIV notifications in 2024 for whom risk factor data were available (63.2%), 9 were of people who inject drugs (PWID), compared with 29 in 2023 and 35 in 2022. The figure for 2022 was the highest number of PWID among HIV notifications since 2015.

Recent trends indicate that the number of cases of HBV diagnosed and notified in Ireland is stabilising rather than continuing to decline. Of the acute HBV cases notified in 2024 (n=14), none were PWID. There were 462 HCV notifications in Ireland in 2024, a decrease of 14% on 2023, when there were 537 notifications. There has been a downward trend in HCV notifications since peak numbers (n=1538) were recorded in 2007. Information on the most likely risk factor was available for 44.4% (n=205) of cases in 2024. Of cases with risk factor data, 130 were PWID and 5 were infected through contaminated blood products.

Harm reduction services available in Ireland include needle exchange programmes from fixed sites, mobile units, and outreach work provided by regional authorities and community-based organisations (CBOs). In addition, there are pharmacies providing a needle exchange service in each Regional Drug and Alcohol Task Force (RDATF) area within Ireland. At the end of 2024, there were 84 pharmacies providing a needle exchange service. According to the most recent available data, there were 342,161 individual syringes exchanged in Ireland in 2024.

A recent study has revealed a sharp increase in cocaine use and associated health harms in Ireland over the past two decades. Hospitalisations, psychiatric admissions, treatment episodes, and deaths related to cocaine use have all risen dramatically over this time period. For example, cocaine-related hospital discharges increased from 1.4 per 100,000 population in 2000 to 24.3 per 100,000 population in 2022. Treatment entrants reporting cocaine as their main problem drug increased from 1.5 per 100,000 population in 2000 to 93.2 per 100,000 population in 2023, while cocaine-related poisoning deaths rose from 0.13 to 2.6 per 100,000 between 2000 and 2020.